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Ursodeoxycholic acid–induced changes of plasma and urinary bile acids in patients with primary biliary cirrhosis
Author(s) -
Stiehl Adolf,
Rudolph Gerda,
Raedsch Richard,
Moller Bernd,
Hopf Ulrich,
Lotterer Erich,
Bircher Johannes,
Fölsch Ulrich,
Klaus Jürgen,
Endele Richard,
Senn Martin
Publication year - 1990
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.1840120308
Subject(s) - ursodeoxycholic acid , taurine , medicine , bile acid , primary biliary cirrhosis , biliary cirrhosis , endocrinology , cholic acid , cirrhosis , endogeny , chemistry , glucuronidation , amino acid , biochemistry , microsome , enzyme , disease , autoimmune disease
Ursodeoxycholic acid treatment of patients with primary biliary cirrhosis may lead to relief of pruritus and improvement of biochemical liver tests. The changes in serum and urinary bile acids induced by ursodeoxycholic acid treatment were studied. After 29 patients with primary biliary cirrhosis were treated with ursodeoxycholic acid (750 to 1,000 mg/day) for 6 to 12 mo because of an increase in ursodeoxycholic acid, total plasma bile acids increased from 30.5 ± 6 μmol/L (mean ± S.E.M.) to 52.7 ± 11.7 μmol/L (p < 0.01). The increase in total plasma bile acids correlated significantly with concentrations of plasma bile acid before treatment (p < 0.01). The concentrations of endogenous bile acids decreased, mainly because of a decrease of cholic acid. During treatment, glycine conjugation increased and taurine conjugation decreased, whereas sulfation and glucuronidation of bile acids were unchanged. In 10 patients with primary biliary cirrhosis in stages III and IV, urinary excretion of bile acids was also studied. After treatment, ursodeoxycholic acid and its 3‐β isomer and C‐1–hydroxylated and C‐6–hydroxylated derivatives were also excreted. During treatment, urinary excretion of endogenous bile acids decreased. The increase of ursodeoxycholic acid and the decrease of endogenous bile acids may both be related to the improvement of biochemical liver tests in precirrhotic stages of the disease. In cirrhosis, endogenous bile acids in plasma remained high and changes in liver tests were small. (H EPATOLOGY 1990;12:492–497).